International Journal of Infection
Volume:6 Issue: 4, Oct 2019

Polymyxins, especially polymyxin B and colistin (polymyxin E), are the last resort antibiotics among a few reserve antibiotics still showing potentiality against Gram-negative superbugs. Globally, during the alarming situation of fast-spreading antibiotic resistance in Gram-negative bacteria, the therapeutic application of polymyxins should be rational and target-specific considering their pharmacokinetic (PK) and pharmacodynamic (PD) characteristics. Intravenous polymyxin B shows relatively higher plasma protein binding and excessive renal tubular reabsorption; it invariably exists in the plasma for longer periods, maintaining the minimum inhibitory concentration (MIC) properly, and mostly are excreted out through a nonrenal pathway. On the other hand, intravenous inactive colistimethate sodium is bio-converted in the blood and kidneys into the active colistin moiety that manifests relatively higher colistin concentration in the urinary tract for longer duration possessing the MIC statically. This study comprehensively evaluated the PK and PD data of polymyxins assuming that the therapeutic specification of polymyxin B in bloodstream infections and colistin in urinary tract infections caused by multidrug-resistant Gram-negative bacteria may be an intelligent approach during the emergence of antibiotic resistance. The therapeutic specification of polymyxins may effectively reduce the progression of polymyxin resistance and optimize its therapeutic outcomes in the treatment of life-threatening infections.

Multidrug-resistant organisms have become an increasing challenge in the management of both solid and non-solid organ transplants. This is especially true with extended spectrum beta-lactamases (ESBL) and carbapenem-resistant Enterobacteriaceae (CRE) infections. We performed a retrospective study of 62 renal transplant recipients at a tertiary care center in El Paso, Texas. In our study population, 43% of patients had a positive urine culture and were treated for a UTI. 30% of those UTIs were caused by an ESBL-producing organism. Of note, 43% of the patients who developed a UTI also had a recurrent episode. Notably, one patient had 25 recurrences of UTIs caused by ESBL producing E. coli. K. pneumoniae and E. coli were the most commonly cultured non-ESBL-producing bacteria (40.7%). E. coli was the most frequently cultured ESBL-producing bacteria (62.5%), while K. pneumoniae was the second most frequently cultured ESBL-producing bacteria (37.5%). There were three transplant rejections; two had ESBL UTIs and one had 11 recurrent UTIs prior to rejection. Diabetes, the length of ureteral stents, and higher troughs of immunosuppressant therapy were observed to be correlated with higher rates of UTIs in our patient population. Our findings are consistent with reports published in current literature regarding rates of UTIs among renal transplant recipients. Due to increasing prevalence of multi-drug resistant organisms and increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE), it becomes imperative for clinicians to include CRE in the differential diagnosis when evaluating renal transplant recipients with recurrent UTIs. More importantly, CRE must be considered when evaluating renal transplant recipients with recurrent UTIs caused by ESBL producing organisms.

Malaria and hepatitis B virus (HBV) are two diseases of major medical importance in Nigeria.

The study determined the preponderance of malaria, HBV and their co-infection among 600 outpatients of three major hospitals in Port Harcourt, Nigeria, using standard microscopic method and rapid serology assay diagnostic kit.

Total preponderance rate of malaria, HBV, and co-infection was observed to be 41.0%, 6.0%, and 4.33%, respectively. The female gender was more infected with malaria (44.67%) than the male counterparts (37.54%), while the males were more infected with HBV (7.12%) and co-infection (5.18%) than the females with 4.8% and 3.44%, respectively. The infection rate between genders was not statistically significant (P > 0.05). The prevalence of malaria was statistically high among the age group of 21 - 30 years (55.66%) (P < 0.05). HBV and co-infection prevalence rate was statistically the highest among the age group of 21 - 30 years with 11.76% and 10.3% rates of infection, respectively.

The high rate of malaria prevalence and the presence of HBV and co-infection among the study subjects imply that these infections are threats to the human health and strategies should be adopted to help combat and control these infections.

Coxiella burnetii is the cause of Q fever. There is no adequate information about Q fever in rural pregnant women in Iran.

The aim of this study was to investigate the seroprevalence of C. burnetii infection among rural pregnant women with historical contact with livestock in Khorramabad (western Iran).

This cross-sectional was conducted from December 2016 to June 2017 on 184 samples collected randomly from rural pregnant women who referred to clinical laboratories and health centers in Khorramabad. The data were examined using indirect ELISA assay kits for the detection of C. burnetii phase II human antibodies in their serum samples.

Of 184 serum samples of rural pregnant women, 89 (48.4%) were positive, 76 (41.3%) negative, and 19 (10.3%) suspected. In addition, there was a significant relationship between age, pregnancy, abortion, and the location of the village relative to the city. The results suggested that more positive samples were observed in women that lived in the eastern villages of Khorramabad city; however, the difference was not statistically significant (P value = 0.535).

The present study demonstrated the high seroprevalence of C. burnetii in rural pregnant women, which necessitates preventing the unwanted side effects of the disease. Rural pregnant women should pay more attention to the disease and its dangerous effects.

Hepatitis B virus (HBV) and human papillomavirus (HPV) infections remain a major public health problem in sub-Saharan countries including Nigeria.

The study investigated the prevalence of HBV, HPV, and their co-infection in 510 outpatients of two major hospitals in both Kwara and Ondo States, Nigeria, employing the use of rapid serology assay diagnostic kit for HBV and HPV Enzyme-Linked Immunosorbent assay (ELISA) kit.

The overall preponderance rate of both infections was observed to be 11.4%, including 6.3% hepatitis B and 5.1% HPV. The co-infection prevalence was observed to be 0.58%. Females were more infected with HBV (6.8%) and HPV (5.7%) than male counterparts with 5.3% and 4.3%, respectively. Furthermore, married-single subjects had a higher rate of co-infection (1.4%) than their married counterparts (0.56%). The rate of infection between male and female genders was not significantly different (P > 0.05). However, the prevalence of HPV was statistically higher among married-single subjects (7.2%) (P < 0.05). The HBV and co-infection prevalence rates were statistically higher among married-single subjects with 8.7% and 1.4%, respectively.

The prevalence of HBV and co-infection with HPV observed in this study indicates the public health threats posed by these infections and further establishes the need for the Nigerian Health System to strengthen domestic initiatives that are strategically geared towards eliminating hepatitis and improving access to affordable diagnostics, enabling linkage to care and treatment of infected individuals.

Sexually transmitted infections (STIs) are a subject of great concern in public health, particularly in the field of reproductive medicine.

This study aimed to detect the presence of two sexually-transmitted bacteria, C. trachomatis and N. gonorrhoeae, in the semen samples of infertile men referred to a medical diagnostic laboratory in Rafsanjan city by PCR and also to investigate their possible effects on semen parameters.

Semen samples of 309 infertile men who were asymptomatic for genital tract infections were evaluated using the PCR method. In addition, the analysis of semen parameters was performed according to the WHO guidelines.

The average age of the participants was 32.67±17.02 years and 11.65% of cases were positive at least for one of the two tested bacteria; 11.32% for C. trachomatis and only 0.32% for N. gonorrhoeae. Furthermore, there was a direct significant correlation between chlamydia infection and at least two variables of sperm quality; activity, and live ratio (P < 0.05).

The results demonstrated that C. trachomatis are widespread among males, and this infection may lead to an effect on semen parameters such as activity and live ratio.